Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,207.73 / $1,207.73 / $1,207.73	Facility		$1,207.73	$1,207.73	$1,207.73
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,172.56 / $1,207.73 / $1,289.81	Professional		$1,172.56	$1,207.73	$1,289.81
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,172.56 / $1,172.56 / $1,758.84	Professional		$1,172.56	$1,172.56	$1,758.84
CareSource Facility/Professional Facility Modifier Low / Median / High Price $1,605.34 / $1,876.10 / $1,876.10	Facility		$1,605.34	$1,876.10	$1,876.10
Cigna Facility/Professional Facility Modifier Low / Median / High Price $1,390.26 / $2,543.32 / $3,604.77	Facility		$1,390.26	$2,543.32	$3,604.77
Cigna Facility/Professional Professional Modifier Low / Median / High Price $150.02 / $1,090.15 / $1,323.00	Professional		$150.02	$1,090.15	$1,323.00
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $221.14 / $1,207.73 / $1,847.83	Facility		$221.14	$1,207.73	$1,847.83
Medica Facility/Professional Facility Modifier Low / Median / High Price $221.14 / $1,200.34 / $1,800.53	Facility		$221.14	$1,200.34	$1,800.53
Medica Facility/Professional Professional Modifier Low / Median / High Price $1,165.39 / $1,165.39 / $2,447.32	Professional		$1,165.39	$1,165.39	$2,447.32
Molina Facility/Professional Professional Modifier Low / Median / High Price $50.00 / $60.00 / $85.00	Professional		$50.00	$60.00	$85.00
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $221.14 / $1,207.73 / $1,847.83	Facility		$221.14	$1,207.73	$1,847.83
Quartz Facility/Professional Professional Modifier Low / Median / High Price $641.91 / $1,172.56 / $1,825.21	Professional		$641.91	$1,172.56	$1,825.21
Quartz Facility/Professional Facility Modifier Low / Median / High Price $1,172.56 / $1,192.50 / $3,675.00	Facility		$1,172.56	$1,192.50	$3,675.00
Quartz Facility/Professional Professional Modifier Low / Median / High Price $1,172.56 / $1,431.00 / $4,725.00	Professional		$1,172.56	$1,431.00	$4,725.00
Security Health Facility/Professional Professional Modifier Low / Median / High Price $1,646.27 / $1,646.27 / $1,646.27	Professional		$1,646.27	$1,646.27	$1,646.27
United Facility/Professional Professional Modifier Low / Median / High Price $1,172.56 / $1,172.56 / $1,407.07	Professional		$1,172.56	$1,172.56	$1,407.07